When overactive bladder and urge incontinence do not respond to more conservative therapy, one option to reduce frequency and urgency and increase bladder capacity is to inject Botox into the bladder muscle (detrusor). The treatment lasts between 3-6 months and must be repeated to have continued effect. It has been shown to be an effective treatment for overactive bladder and urge incontinence. Potential risks include incomplete bladder emptying, urinary tract infection, temporary difficulty emptying (in very rare cases requiring self-catheterization for a short time). It is done as an office procedure with local anesthetic, and has essentially no “down time.” It can be a very satisfactory treatment for OAB when physical therapy and medications are not effective or adequate.